Tech's peer-to-peer model is coming for insurance (2024)

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The same innovation tech brought to finance and consumers is coming for what the U.S. Treasury calls the $1 trillion-per-year domestic insurance market.

Much like the way Groupon leveraged the buying power of groups and peer-to-peer lender Lending Club cut out the middle man to offer lower rates for borrowers, new start-ups are looking to lower insurance premiums and open the door to outside investors. (Tweet This)

In some cases, it's even the same group of people. Visar Nimani, Lending Club's former CTO, spent months with his team—including fellow Lending Club alumni—exploring how to apply the same marketplace they built for loans to the insurance sector at his new start-up, Uvamo.

"Insurance companies obviously make significant amounts of money, they run commercials," he joked. "But the average investor hasn't had a way to get involved with that." Uvamo wants to change that.

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How would it work?

Today, the insurance business tends to have high overhead costs, and too much of the premiums consumers pay aren't purely going into covering losses, Nimani said.

Uvamo, which plans to launch by the end of the year, aims to cut administrative costs by offering property and casualty insurance direct to consumers online. Those policies can then be diversified and grouped into a pool, which collects all the premiums paid by the policyholders.

There's also an opportunity for outside investors, who can invest money to back that pool of policies, making up the required capital reserve.

Investors—and Uvamo—profit from whatever money's left in the premium pool after all claims have been paid out. And while those pooled premiums are typically enough to cover a pool's cost of claims, outside investors' funds would cover the remainder if they aren't, Nimani said.

Investors would only be on the hook for the money they originally invest—Uvamo would be responsible for the any claims that go beyond the money in the pool, Nimani said. When the policies of a pool expire, investors are returned their original investment, plus the excess in premiums leftover after Uvamo takes a small percentage.

Funds themselves can be rated for risk similar to the way personal or business loans are with peer-to-peer financing, giving investors risk flexibility. Take auto insurance as an example, which Uvamo hopes to offer after launching. In lieu of a credit score, a driver's history as well as all other basic information insurers typically receive, could help score the riskiness of any given fund.

Beyond offering flexibility and relatively low-risk returns, access to insurance offers a distinct way for investors to diversify risk across a portfolio. "The beauty of insurance is that it's not tied to economic downturns," Nimani said. "It will be a very important risk diversification asset for investors."

Of course, Uvamo faces strict regulations similar to what Lending Club experienced when starting out. Terri Vaughan, former CEO at the National Association of Insurance Commissioners, says Uvamo will face not only securities regulation, but also strict scrutiny from insurance regulators who must ensure "any insurance company has enough money there to be paid to policyholders."

"I understand the need for that regulation though," Nimani said. "It's necessary any time you're taking money from a consumer and making a promise." The fact that insurance in the U.S. is regulated state by state isn't making things any easier. With different state laws come different intricacies and the per-state licensing costs can be quite high.

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It's that regulation coupled with a high capital requirement that doesn't bode well for a typical start-up, but Nimani is confident as Uvamo launches its Series A funding round. And even if the tech company can only repeat half the success Lending Club has had so far, it could still become a more than $3 billion business in the insurance world.

Should insurers be worried?

Not all new insurance modes are being built with the goal of replacing big companies. Bought By Many, a U.K.-based insurance start-up in its fourth year, operates as a broker between insurers and customers, helping both in the process.

It looks to leverage the buying power of groups, similar to the way Groupon can get businesses to offer discounts by guaranteeing customers. But instead of using that collective buying power to bring about discounts, Bought By Many uses the leverage to secure lower premiums for individuals seeking similar insurance coverage.

And while the company says that leverage has led to about a 20 percent reduction in premiums for groups, it's also brought coverage to customers who have notoriously had a hard time finding insurance in the first place. Pet owners, for example, were among the first who were able to demand more comprehensive policies that included specialized coverage for problems that are often unique to a specific breed. Now, Bought By Many boasts over 100 different pet groups, and co-founder Steven Mendel says it's exactly that same specialization and group buying power helping elder customers and those with existing conditions find their perfect policy at a fair price.

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That's also helping insurers maintain satisfied customers. "We help them target the risks they want, but at a lower cost and more precisely than they can reach themselves," he said.

After closing its second round of funding with private investors, Mendel says the company is looking to broaden coverage into other areas, such as policies negotiated specifically for employees at start-ups, and will look to expand operations into another country. But due to the U.S. insurance regulations Uvamo knows all too well, don't expect Bought By Many to cross the pond anytime soon.

And while the solutions of Uvamo and Bought By Many may differ in structure, Mendel says the sleepy industry's problem they are attempting to fix is one and the same. "Insurance hasn't changed for decades," he said. "Yet the rest of the world has moved on enormously."

Tech's peer-to-peer model is coming for insurance (2024)

FAQs

What does peer-to-peer mean in insurance? ›

Peer-to-peer (P2P) insurance is a product that allows a group of insureds to pool their capital, self-organize, and self-administer their own insurance.

How do I prepare for a peer-to-peer insurance review? ›

Be succinct and provide objective facts from the clinical notes. Consider that the payer may not have complete information about the patient's symptoms, test results, and care. Ask the payer's medical director what they know about the patient, or ask them why they denied your request for services.

What are the advantages of peer-to-peer insurance? ›

One of the main benefits is that members can receive excess premiums back, and they have more control over management decisions. Downsides include the possibility of less coverage than a traditional insurer could provide.

What does peer-to-peer mean in healthcare? ›

A peer-to-peer process is a conversation between the member's clinician and a PacificSource medical director about clinical reasoning used in a non-approval decision. The purpose is to provide information (but not to change the decision).

How does peer-to-peer work? ›

In a peer-to-peer network, computers on the network are equal, with each workstation providing access to resources and data. This is a simple type of network where computers are able to communicate with one another and share what is on or attached to their computer with other users.

What are the disadvantages of P2P insurance? ›

The problem with P2P insurance is that the model is not scalable. The advantages of this model only work in a small-scale setting. If millions of people are added under this model, it may become unsustainable and may end up causing more problems than benefits.

How to win peer-to-peer review? ›

Follow these five strategies for crafting a constructive and productive approach to peer-to-peer conversations:
  1. Prepare Thoroughly. Thorough preparation starts with creating a timeline. ...
  2. Build Rapport and Respect. ...
  3. Keep a Positive Perspective. ...
  4. Maintain a Clinical Lens. ...
  5. Set Firm Boundaries.
Jan 6, 2022

What not to do in a peer review? ›

Reviews should be unbiased, respectful, and constructive. Personal attacks that call an author's character into question should never be included in a peer review. If a reviewer cannot ensure this, then they should recuse themselves from the review.

How long does a peer-to-peer review take? ›

The time required for peer review varies depending on a number of factors such as the availability of peer reviewers and the existing backlog of papers for initial assessment and review. Typically, when a paper is considered for peer review, each round of peer review takes approximately 45-90 days.

What is a peer review for insurance? ›

A medical peer review is initiated by a health insurer to determine whether the medical treatment provided for a covered person is compensable or not.

What is peer-to-peer model advantages and disadvantages? ›

The main advantages of P2P include reducing the load and cost of servers, increasing the availability and reliability of resources, and enhancing the privacy and anonymity of nodes. However, P2P can also be difficult to manage and secure due to varying capabilities, configurations, and trust levels among nodes.

What is a peer-to-peer for prior authorization? ›

This is a process in which an ordering physician discusses the need for a procedure or drug with another physician who works for the payer in order to obtain a prior authorization approval or appeal a previously denied request.

What is an example of peer-to-peer insurance? ›

Examples are liability insurance, household contents insurance, legal expenses insurance and electronics insurance. In the carrier model, the only requirement is that the group members have something in common, such as being members of the same club or believing in the same charity.

What is an example of a peer-to-peer? ›

For instance, applications such as Skype and WhatsApp use P2P communication to enable users to chat and make voice and video calls directly with each other. Messages and media files are exchanged between users without needing a central server.

Is there a CPT code for peer-to-peer review? ›

Unfortunately, at this time, there is not a CPT code for a peer-to-peer review call. This service is considered part of the administrative work associated with patient care and not separately coded.

What is considered peer-to-peer? ›

A peer-to-peer (P2P) service is a decentralized platform whereby two individuals interact directly with each other, without intermediation by a third party.

What is the meaning of peer-to-peer loan? ›

Peer-to-peer lending, also abbreviated as P2P lending, is the practice of lending money to individuals or businesses through online services that match lenders with borrowers.

What is peer-to-peer contract? ›

The official business definition of a Peer-to-Peer (P2P) Contract is a type of agreement between two or more parties, where each party agrees to provide goods, services, or financial assets to the other party in exchange for something of value.

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